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Ioana Grigore

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

SISTEMUL DE CLASIFICARE A FUNCTIEI MOTORII GROSIERE SI SISTEMUL DE CLASIFICARE A ABILITATII MANUALE IN EVALUAREA PARALIZIEI CEREBRALE

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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SISTEMUL DE CLASIFICARE A FUNCTIEI MOTORII GROSIERE SI SISTEMUL DE CLASIFICARE A ABILITATII MANUALE IN EVALUAREA PARALIZIEI CEREBRALE

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REZUMAT

Paralizia cerebrală (PC) este o boală cerebrală cronică, definită ca un grup de afecţiuni motorii neprogresive care debutează în primul an de viaţă şi care sunt secundare leziunilor survenite la un creier aflat în dezvoltare. La vârsta pediatrică este principala cauză a tulburărilor motorii severe şi invalidante.
Obiectivul lucrării. Încadrarea comparativă în diverse grade de severitate a PC la copil aplicând cele două clasificări: Sistemul de Clasificare a Funcţiei Motorii Grosiere (Gross Motor Function Classification System – GMFCS) şi Sistemul de Clasificare a Abilităţii Manuale (Manual Ability Classification System – MACS).
Material şi metodă. Grupul de studiu a cuprins 129 de copii (43 de fete şi 86 de băieţi), cu vârste cuprinse între 2-18 ani, diagnosticaţi cu diferite forme de PC. Protocolul de studiu a inclus examen clinic general şi examen neurologic.
Rezultate. Dintre pacienţii cu PC urmăriţi, 24 (18,60%) au fost încadraţi la gradul I atât în clasificarea GMFCS, cât şi în MACS. De asemenea, dintre cei 69 de copii care puteau merge independent (GMFCS I+II), 60 aveau dexteritate manuală bună sau foarte bună (MACS I+II). În formele severe de PC (GMFCS V), 32/35 bolnavi nu puteau mânui obiectele fiind încadraţi în MACS V şi 3 puteau manipula numai anumite obiecte, fiind incluşi în MACS IV.
Concluzii. Funcţia motorie grosieră şi abilitatea manuală evoluează pe paliere diferite de gravitate în funcţie de tipul PC. În PC diskinetică, ataxică şi mixtă, s-a remarcat o mai mare corespondenţă între gradele de severitate conturate de cele două clasificări.

Keywords: paralizie cerebrală, funcţie motorie, abilitate manuală, copil

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GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM AND MANUAL ABILITY CLASSIFICATION IN CEREBRAL PALSY EVALUATION

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM AND MANUAL ABILITY CLASSIFICATION IN CEREBRAL PALSY EVALUATION

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ABSTRACT

Cerebral palsy (CP) is a chronically cerebral disease, which is defined like a group of non-progressives motor diseases that onset in the first year of life and are the secondary lesions for a developed brain. At pediatric age CP is the most frequent cause of severe and infirmity motor problems.
Aim of the study. Comparative framing in various degrees of severity for CP at child applying two classifications: Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS).
Material and Methods. The study group included 129 children (43 girls and 86 boys) aged 2-18 years, diagnosed with various forms of CP. The study protocol included general clinical examination, neurological exam.
Results. Of patients with CP watch, 24 (18,60%) were employed in both the grade I classification GMFCS and MACS. Also, of the 69 children who could walk independently (GMFCS I+II), 60 had good manual dexterity or very good (MACS I+II). Of the 35 patients with severe forms of PC (GMFCS V), 32 could not wield the objects being impressed into MACS V and 3 could handle only certain items being included in MACS IV.
Conclusions. The gross motor function and the manual ability evolve on different levels of severity depending on type of CP. In diskinetic CP, ataxic CP and mixed forms of CP was noticed a higher correlation between the grades of the two classifications.

Keywords: cerebral palsy, motor function, manual ability, child

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COMPLICATII CARDIACE IN DISTROFIA MUSCULARA DUCHENNE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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COMPLICATII CARDIACE IN DISTROFIA MUSCULARA DUCHENNE LA COPIL

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REZUMAT

Complicaţiile cardiace sunt frecvent diagnosticate în distrofia musculară Duchenne (DMD), manifestările clinice fiind în general evidente după vârsta de 10 ani. Înregistrările electrocardiografice au obiectivat la aceşti pacienţi diferite modificări, cele mai frecvente fiind reprezentate de unde R ample în precordialele drepte, unde Q profunde stângi, tulburări de conducere şi aritmii. Examenul ecocardiografic poate obiectiva prezenţa disfuncţiilor cardiace subclinice la copiii cu vârstă sub 12 ani diagnosticaţi cu DMD. La pacienţii la care examenul ecocardiografic standard este în limite normale, indexul de performanţă miocardic este un parametru util în de pistarea precoce a anomaliilor cardiace asimptomatice. Rezonanţa magnetică cardiovasculară oferă informaţii atât cu privire la funcţia sistolică a ventriculului stâng, cât şi a modificărilor ţesutului miocardic şi a apariţiei fibrozei, leziuni ce rar pot fi obiectivate înaintea vârstei de 10 ani. Toate aceste explorări trebuie avute în vedere la copiii cu DMD la finalul unui bilanţ neurologic complet.

Cuvinte cheie: manifestări cardiace, distrofie musculară Duchenne, copil

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CARDIAC COMPLICATIONS IN DUCHENNE MUSCULAR DYSTROPHY IN CHILDREN

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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CARDIAC COMPLICATIONS IN DUCHENNE MUSCULAR DYSTROPHY IN CHILDREN

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ABSTRACT

Cardiac complications are frequently diagnosed in Duchenne muscular dystrophy (DMD), clinical manifestations generally appear after age 10. ECG recordings objectified various changes in these patients, the most common being represented by extensive R waves in V1, left deep Q waves, conduction abnormalities and arrhythmias. Echocardiographic examination may objective the presence of subclinical cardiac dysfunction in children under 12 years old diagnosed with DMD. In patients where standard echocardiographic examination is normal, myocardial performance index is a parameter useful in early detection of asymptomatic cardiac abnormalities. Cardiovascular magnetic resonance provides information both on left ventricular systolic function and myocardial tissue changes and occurrence of fibrosis, lesions rarely objectified before the age of 10 years. All these explorations should be considered in children with DMD at the end of a complete neurological exam.

Keywords: cardiac manifestations, Duchenne muscular dystrophy, child

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Non-ketotic hyperglycinemia

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Non-ketotic hyperglycinemia

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ABSTRACT

Non-ketotic hyperglycinemia (NKHG) is an inborn error of glycine metabolism in which large quantities of glycine accumulate in all body tissues, including the brain. This accumulation in central nervous system produces hyperexcitability of neurons and seizures. We report a case of non-ketotic hyperglycinemia in a newborn.

Key words: hypotonia, unexplained coma, seizures, non-ketotic hyperglycinemia, newborn

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HIPERGLICINEMIA NONCETONICA

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

HIPERGLICINEMIA NONCETONICA

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REZUMAT

Hiperglicinemia noncetonică (HGNC) este o boală genetică a metabolismului glicinei, în care se acumulează cantităţi crescute de glicină în toate ţesuturile, inclusiv în creier. Această acumulare în sistemul nervos central determină hiperexcitabilitate neuronală şi convulsii. Prezentăm un caz de hiperglicinemie noncetonică, reformă neonatală.

Cuvinte cheie: hipotonie, comă inexplicabilă, convulsii, hiperglicinemie noncetonică, nou-născut

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Neurological manifestations in children with autism

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Neurological manifestations in children with autism

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ABSTRACT

The autism is a pervasive developmental disorder that can be associated with various neurological disorders. The aim of this study is to evaluate the incidence and characteristics of neurological abnormalities, the presence of epileptic seizures and/or EEG abnormalities in children with autism. Our study included 34 children (aged 2.5 to 13 years) diagnosed with autism. The study protocol included: general physical and neurological examination, IQ, tests of language, behavior, auditory attention, social skills and play, clinical features of epileptic seizures, EEG recordings. Neurological exam revealed mild hypotonia in 19 (55.88%) patients with autism, hyporeflexia in 21 (61.76%), the presence of stereotype movements in 24 (70.58%) and abnormalities of gait in 5 (14,80%) cases. Epileptic seizures were present in 9 children. EEG changes were present in all children diagnosed with autism and epilepsy, but also in those with no clinically critical episodes; they were represented by nonepileptic type in 29.41% cases and epileptic abnormalities in 44.12%. The changes of tone and reflexes, seizures and epileptic discharges were particularly common in children studied with autism. Our data suggests that EEG evaluation is important for these patients. The management of epilepsy in autism consists in the administration of antiepileptic drugs that, in addition to seizures control, also interfere with mood and behavioral disturbance observed in autism.

Key words: autism, child, epilepsy, EEG abnormalities, neurological abnormalities

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MANIFESTARI NEUROLOGICE LA COPIII CU AUTISM

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

MANIFESTARI NEUROLOGICE LA COPIII CU AUTISM

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REZUMAT

Autismul este o afecţiune pervazivă de dezvoltare care se poate asocia cu diferite probleme neurologice. Scopul acestui studiu a fost de a evalua incidenţa şi caracteristicile anomaliilor evidenţiate la examenul neurologic, prezenţa crizelor epileptice şi/sau anomaliile EEG la copiii cu autism. În studiu au fost incluşi 34 de copii cu vârste cuprinse între 2 ani şi 5 luni-13 ani, diagnosticaţi cu autism. Protocolul de studiu a inclus: examenul clinic general şi neurologic, QI, evaluarea limbajului, comportamentului, atenţiei, abilităţilor sociale şi a jocului, caracteristicile clinice ale crizelor epileptice, înregistrarea EEG. Examenul neurologic a evidenţiat hipotonie musculară la 19 (55,88%) pacienţi, diminuarea reflexelor osteotendinoase la 21 (61,76%), prezenţa mişcărilor stereotipe la 24 (70,58%) şi anomalii ale mersului la 5 (14,70%) dintre copiii cu autism evaluaţi. Crize epileptice au prezentat 9 copii. Modificările EEG au fost prezente la toţi copiii diagnosticaţi cu autism şi epilepsie, dar şi la cei care nu prezentau clinic episoade critice, fiind reprezentate de anomalii neepileptice în 29,41% din cazuri şi de tip epileptic în 44,12%. Modificările de tonus muscular şi de reflexe, crizele şi descărcările epileptice au fost comune la copiii cu autism. Rezultatele studiului actual demonstrează că evaluarea EEG este importantă la aceşti pacienţi. Abordarea terapeutică a epilepsiei în autism a constat în administrarea de medicamente antiepileptice care, pe lângă controlul crizelor, au influenţat favorabil atât dispoziţia, cât şi comportamentul.

Cuvinte cheie: autism, copil, epilepsie, modificări EEG, anomalii neurologice

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Efficacy of Levetiracetam in children with drug resistant partial seizures

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Efficacy of Levetiracetam in children with drug resistant partial seizures

, , , , and

ABSTRACT

Epilepsy is frequently diagnosed in the pediatric age raising numerous issues related to treatment. Levetiracetam (LEV) is an antiepileptic drug (AED) which is approved as a new combination therapy in different types of drug resistant seizures. The purpose of this study was to evaluate the efficacy and safety of LEV in combination with drug resistant therapy in partial epilepsies children. The study group included 63 children diagnosed with various forms of partial epilepsy. All patients received antiepileptic medication in monotherapy or polytherapy without remission of seizures. Levetiracetam has been associated with MAE initial dose of 10 mg/kg/day (two administrations), the dose was increased up to 40 mg/kg/day within 6 weeks. Patients were studied for a further period of six months. Among children who received associated LEV 34 (53.96%) showed a reduction > 50% of seizures, and 21 (33.35%) reduction was <50%. 8 (12.69%) of patients achieved complete control of critical episodes. Side effects recorded during the study were minimal, being represented by fatigue (12 cases), conduct disorder (7 cases), sleepiness at baseline (three cases), decreased appetite (4 cases), and vomiting (2 cases). Levetiracetam combination treatment in children with drug resistant partial epilepsy is effective with complete control or significant reduction in seizure frequency. Clinical response in the group of studied children was favorable especially in patients with partial motor seizures with or without secondary generalization. Levetiracetam was generally well tolerated, side effects occurred in the study being minimal.

Key words: Levetiracetam, child drug resistance, partial seizures

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EFICACITATEA TRATAMENTULUI CU LEVETIRACETAM LA COPIII CU CRIZE EPILEPTICE PARTIALE FARMACOREZISTENTE

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EFICACITATEA TRATAMENTULUI CU LEVETIRACETAM LA COPIII CU CRIZE EPILEPTICE PARTIALE FARMACOREZISTENTE

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REZUMAT

Epilepsia este frecvent diagnosticată la vârsta pediatrică, ridicând numeroase probleme legate de tratament. Levetiracetamul (LEV) este un medicament antiepileptic (MAE) nou care este aprobat ca tratament de asociere în diferite tipuri de crize epileptice farmacorezistente. Scopul acestui studiu a fost de a evalua eficacitatea şi siguranţa asocierii LEV în tratamentul epilepsiilor parţiale farmacorezistente la copii. Lotul de studiu a cuprins 63 de copii diagnosticaţi cu diferite forme de epilepsie parţială. Toţi pacienţii primeau medicaţie antiepileptică în mono sau politerapie fără remiterea crizelor. Levetiracetamul a fost asociat la MAE iniţială în doză de 10 mg/kg/zi (în două administrări), doză ce a fost crescută până la maxim 40 mg/kg/ zi în decurs de 6 săptămîni. Pacienţii au fost urmăriţi în continuare pe o perioadă de 6 luni. Dintre copiii urmăriţi la care s-a asociat LEV 34 (53,96%) au prezentat o reducere a crizelor cu >50%, iar la 21 (33,35%) reducerea a fost <50%. La 8 (12,69%) dintre pacienţi s-a obţinut controlul complet al episoadelor critice. Efectele secundare înregistrate pe durata studiului au fost minime, fiind reprezentate de fatigabilitate (12 cazuri), tulburări de comportament (7 cazuri), somnolenţă iniţială (3 cazuri), scăderea apetitului (4 cazuri), vărsături (2 cazuri). Asocierea LEV la tratamentul copiilor cu epilepsii parţiale farmacorezistente este eficientă în controlul complet sau în scăderea semnificativă a frecvenţei crizelor. Răspunsul clinic în grupul de copii studiat a fost favorabil în special la pacienţii cu crize parţiale motorii cu sau fără generalizare secundară. Levetiracetamul a fost în general bine tolerat, efectele secundare apărute în studiu fiind minime.

Cuvinte cheie: levetiracetam, crize epileptice parţiale farmacorezistente, copil

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